Arthroscopic suturing techniques and instruments have been developed to facilitate the suturing of tissue during arthroscopic surgical procedures. In arthroscopic surgery, access to a surgical work site within a patient's body is normally provided through one or more portals formed directly in the patient's body, or through one or more cannulas inserted into the patient's body through small incisions. A chosen surgical procedure is carried out by a surgeon through the use of elongated instruments inserted through these cannulas and it often becomes necessary to suture selected tissue at the surgical work site.
Since the work site is only accessible through a small portal or cannula, and since it is very difficult to tie sutures within the body, various devices and techniques have been developed to enable the surgeon to tie sutures arthroscopically. For example, some procedures enable the surgeon to pass suture material through selected tissue, form a surgical knot extracorporeally and then move the knot with a knot pusher through the portal or cannula into position adjacent the desired tissue to be sutured. Other instruments, such as the suture retriever instruments disclosed and claimed in U.S. Pat. Nos. 6,074,403 and 6,517,564, include a shaft terminating in a sharp tip for piecing tissue and a hinged jaw for capturing and retrieving suture. Still other instruments for passing suture, such as the Suture Lasso, sold by Arthrex, Inc. of Naples, Fla., incorporate a hollow needle for piercing tissue, and a wire loop insertable through the needle for retrieving suture.
Arthroscopic rotator cuff repair is sometimes performed through a superior, percutaneous portal called the Modified Neviaser Portal. As shown in FIG. 1, the Modified Neviaser Portal 50 is located about 1 centimeter posterior to acromioclavicular joint 52 of shoulder 54, midway between the clavicle and spine of the scapula. Due the position of the patient's neck in the Beach Position, it is extremely difficult to pass an instrument, such as those described above, into the shoulder 54 via the Modified Neviaser Portal 50. Accordingly, it would be desirable to provide an instrument and method for rotator cuff repair which can be passed through the Neviaser Portal with the patient in the Beach Position.